DONJON MARINE CO INC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan DONJON MARINE EMPLOYEE WELFARE PLAN
Measure | Date | Value |
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2021: DONJON MARINE EMPLOYEE WELFARE PLAN 2021 401k membership |
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Total participants, beginning-of-year | 2021-06-01 | 282 |
Total number of active participants reported on line 7a of the Form 5500 | 2021-06-01 | 271 |
Total of all active and inactive participants | 2021-06-01 | 271 |
Total participants | 2021-06-01 | 271 |
2020: DONJON MARINE EMPLOYEE WELFARE PLAN 2020 401k membership |
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Total participants, beginning-of-year | 2020-06-01 | 284 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-06-01 | 282 |
Total of all active and inactive participants | 2020-06-01 | 282 |
Total participants | 2020-06-01 | 282 |
2019: DONJON MARINE EMPLOYEE WELFARE PLAN 2019 401k membership |
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Total participants, beginning-of-year | 2019-06-01 | 280 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-06-01 | 284 |
Number of retired or separated participants receiving benefits | 2019-06-01 | 1 |
Total of all active and inactive participants | 2019-06-01 | 285 |
Total participants | 2019-06-01 | 285 |
2018: DONJON MARINE EMPLOYEE WELFARE PLAN 2018 401k membership |
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Total participants, beginning-of-year | 2018-06-01 | 284 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-06-01 | 281 |
Total of all active and inactive participants | 2018-06-01 | 281 |
Total participants | 2018-06-01 | 281 |
2017: DONJON MARINE EMPLOYEE WELFARE PLAN 2017 401k membership |
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Total participants, beginning-of-year | 2017-06-01 | 622 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-06-01 | 494 |
Total of all active and inactive participants | 2017-06-01 | 494 |
Total participants | 2017-06-01 | 494 |
2016: DONJON MARINE EMPLOYEE WELFARE PLAN 2016 401k membership |
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Total participants, beginning-of-year | 2016-06-01 | 743 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-06-01 | 622 |
Total of all active and inactive participants | 2016-06-01 | 622 |
Total participants | 2016-06-01 | 622 |
2015: DONJON MARINE EMPLOYEE WELFARE PLAN 2015 401k membership |
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Total participants, beginning-of-year | 2015-06-01 | 747 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-06-01 | 743 |
Total of all active and inactive participants | 2015-06-01 | 743 |
Total participants | 2015-06-01 | 743 |
2014: DONJON MARINE EMPLOYEE WELFARE PLAN 2014 401k membership |
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Total participants, beginning-of-year | 2014-06-01 | 694 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-06-01 | 747 |
Total of all active and inactive participants | 2014-06-01 | 747 |
Total participants | 2014-06-01 | 747 |
2013: DONJON MARINE EMPLOYEE WELFARE PLAN 2013 401k membership |
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Total participants, beginning-of-year | 2013-06-01 | 811 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-06-01 | 694 |
Total of all active and inactive participants | 2013-06-01 | 694 |
Total participants | 2013-06-01 | 694 |
2012: DONJON MARINE EMPLOYEE WELFARE PLAN 2012 401k membership |
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Total participants, beginning-of-year | 2012-06-01 | 745 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-06-01 | 811 |
Total of all active and inactive participants | 2012-06-01 | 811 |
2011: DONJON MARINE EMPLOYEE WELFARE PLAN 2011 401k membership |
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Total participants, beginning-of-year | 2011-06-01 | 671 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-06-01 | 745 |
Total of all active and inactive participants | 2011-06-01 | 745 |
2010: DONJON MARINE EMPLOYEE WELFARE PLAN 2010 401k membership |
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Total participants, beginning-of-year | 2010-06-01 | 517 |
Total number of active participants reported on line 7a of the Form 5500 | 2010-06-01 | 671 |
Total of all active and inactive participants | 2010-06-01 | 671 |
2009: DONJON MARINE EMPLOYEE WELFARE PLAN 2009 401k membership |
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Total participants, beginning-of-year | 2009-06-01 | 464 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-06-01 | 517 |
Total of all active and inactive participants | 2009-06-01 | 517 |
HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
Policy contract number | 86551 |
Policy instance | 3 |
Insurance contract or identification number | 86551 | Number of Individuals Covered | 271 | Insurance policy start date | 2020-09-01 | Insurance policy end date | 2021-08-31 | Total amount of commissions paid to insurance broker | USD $5,850 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $177,376 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,850 | Insurance broker organization code? | 3 |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00564914 |
Policy instance | 2 |
Insurance contract or identification number | 00564914 | Number of Individuals Covered | 183 | Insurance policy start date | 2020-09-01 | Insurance policy end date | 2021-08-31 | Total amount of commissions paid to insurance broker | USD $3,445 | Total amount of fees paid to insurance company | USD $1,567 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $26,946 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,445 | Amount paid for insurance broker fees | 1567 | Additional information about fees paid to insurance broker | ADDITIONAL FEES | Insurance broker organization code? | 3 |
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HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
Policy contract number | 86551 |
Policy instance | 1 |
Insurance contract or identification number | 86551 | Number of Individuals Covered | 271 | Insurance policy start date | 2020-09-01 | Insurance policy end date | 2021-08-31 | Total amount of commissions paid to insurance broker | USD $88,537 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,303,510 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $88,537 | Insurance broker organization code? | 3 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 099469 |
Policy instance | 4 |
Insurance contract or identification number | 099469 | Number of Individuals Covered | 295 | Insurance policy start date | 2020-06-01 | Insurance policy end date | 2021-07-01 | Total amount of commissions paid to insurance broker | USD $3,167 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $23,897 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,177 | Insurance broker organization code? | 3 |
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HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
Policy contract number | 86551 |
Policy instance | 3 |
Insurance contract or identification number | 86551 | Number of Individuals Covered | 282 | Insurance policy start date | 2019-09-01 | Insurance policy end date | 2020-08-31 | Total amount of commissions paid to insurance broker | USD $5,932 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $174,172 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,932 | Insurance broker organization code? | 3 |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00564914 |
Policy instance | 2 |
Insurance contract or identification number | 00564914 | Number of Individuals Covered | 191 | Insurance policy start date | 2019-09-01 | Insurance policy end date | 2020-08-31 | Total amount of commissions paid to insurance broker | USD $3,319 | Total amount of fees paid to insurance company | USD $433 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $25,690 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,319 | Amount paid for insurance broker fees | 433 | Additional information about fees paid to insurance broker | ADDITIONAL FEES | Insurance broker organization code? | 3 |
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HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
Policy contract number | 86551 |
Policy instance | 1 |
Insurance contract or identification number | 86551 | Number of Individuals Covered | 282 | Insurance policy start date | 2019-09-01 | Insurance policy end date | 2020-08-31 | Total amount of commissions paid to insurance broker | USD $69,116 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,580,724 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $69,116 | Insurance broker organization code? | 3 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 099469 |
Policy instance | 2 |
Insurance contract or identification number | 099469 | Number of Individuals Covered | 296 | Insurance policy start date | 2019-06-01 | Insurance policy end date | 2020-05-31 | Total amount of commissions paid to insurance broker | USD $1,985 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $21,923 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,985 | Insurance broker organization code? | 3 |
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HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
Policy contract number | 86551 |
Policy instance | 3 |
Insurance contract or identification number | 86551 | Number of Individuals Covered | 284 | Insurance policy start date | 2018-09-01 | Insurance policy end date | 2019-08-31 | Total amount of commissions paid to insurance broker | USD $5,633 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $173,086 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,633 | Insurance broker organization code? | 3 |
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HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
Policy contract number | 86551 |
Policy instance | 4 |
Insurance contract or identification number | 86551 | Number of Individuals Covered | 282 | Insurance policy start date | 2018-09-01 | Insurance policy end date | 2019-08-31 | Total amount of commissions paid to insurance broker | USD $12,690 | Welfare Benefit Premiums Paid to Carrier | USD $591,252 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $12,690 | Insurance broker organization code? | 3 |
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HORIZON INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 14690 ) |
Policy contract number | 86551 |
Policy instance | 5 |
Insurance contract or identification number | 86551 | Number of Individuals Covered | 173 | Insurance policy start date | 2018-09-01 | Insurance policy end date | 2019-08-31 | Total amount of commissions paid to insurance broker | USD $4,157 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $44,530 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,157 | Insurance broker organization code? | 3 |
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HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
Policy contract number | 86551 |
Policy instance | 1 |
Insurance contract or identification number | 86551 | Number of Individuals Covered | 282 | Insurance policy start date | 2018-09-01 | Insurance policy end date | 2019-08-31 | Total amount of commissions paid to insurance broker | USD $67,815 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,448,209 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $67,815 | Insurance broker organization code? | 3 |
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HORIZON INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 14690 ) |
Policy contract number | 86551 |
Policy instance | 5 |
Insurance contract or identification number | 86551 | Number of Individuals Covered | 166 | Insurance policy start date | 2017-09-01 | Insurance policy end date | 2018-08-31 | Total amount of commissions paid to insurance broker | USD $3,631 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $35,857 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,631 | Insurance broker organization code? | 3 |
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HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
Policy contract number | 86551 |
Policy instance | 4 |
Insurance contract or identification number | 86551 | Number of Individuals Covered | 287 | Insurance policy start date | 2017-09-01 | Insurance policy end date | 2018-08-31 | Total amount of commissions paid to insurance broker | USD $5,717 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $170,693 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,717 | Insurance broker organization code? | 3 |
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HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
Policy contract number | 86551 |
Policy instance | 1 |
Insurance contract or identification number | 86551 | Number of Individuals Covered | 288 | Insurance policy start date | 2017-09-01 | Insurance policy end date | 2018-08-31 | Total amount of commissions paid to insurance broker | USD $70,294 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,332,032 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $70,294 | Insurance broker organization code? | 3 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 099469 |
Policy instance | 2 |
Insurance contract or identification number | 099469 | Number of Individuals Covered | 306 | Insurance policy start date | 2018-06-01 | Insurance policy end date | 2019-05-31 | Total amount of commissions paid to insurance broker | USD $2,031 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $22,592 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,031 | Insurance broker organization code? | 3 |
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HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
Policy contract number | 86551 |
Policy instance | 3 |
Insurance contract or identification number | 86551 | Number of Individuals Covered | 288 | Insurance policy start date | 2017-09-01 | Insurance policy end date | 2018-08-31 | Total amount of commissions paid to insurance broker | USD $13,876 | Welfare Benefit Premiums Paid to Carrier | USD $639,914 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $13,876 | Insurance broker organization code? | 3 |
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HORIZON INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 14690 ) |
Policy contract number | 86551 |
Policy instance | 4 |
Insurance contract or identification number | 86551 | Number of Individuals Covered | 151 | Insurance policy start date | 2016-09-01 | Insurance policy end date | 2017-08-31 | Total amount of commissions paid to insurance broker | USD $3,523 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $34,745 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
Policy contract number | 86551 |
Policy instance | 1 |
Insurance contract or identification number | 86551 | Number of Individuals Covered | 279 | Insurance policy start date | 2016-09-01 | Insurance policy end date | 2017-08-31 | Total amount of commissions paid to insurance broker | USD $91,908 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,122,819 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 099469 |
Policy instance | 2 |
Insurance contract or identification number | 099469 | Number of Individuals Covered | 215 | Insurance policy start date | 2017-06-01 | Insurance policy end date | 2018-05-31 | Total amount of commissions paid to insurance broker | USD $2,013 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $22,325 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 604175 |
Policy instance | 3 |
Insurance contract or identification number | 604175 | Number of Individuals Covered | 89 | Insurance policy start date | 2017-06-01 | Insurance policy end date | 2018-05-31 | Total amount of commissions paid to insurance broker | USD $9,503 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | LIFESTYLE ADD | Welfare Benefit Premiums Paid to Carrier | USD $63,353 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HORIZON INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 14690 ) |
Policy contract number | 86551 |
Policy instance | 5 |
Insurance contract or identification number | 86551 | Number of Individuals Covered | 10 | Insurance policy start date | 2014-09-01 | Insurance policy end date | 2015-08-31 | Total amount of commissions paid to insurance broker | USD $2,480 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $24,714 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,480 | Insurance broker organization code? | 3 | Insurance broker name | KORE HEALTH AND BENEFITS LLC |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00304119 |
Policy instance | 4 |
Insurance contract or identification number | 00304119 | Number of Individuals Covered | 142 | Insurance policy start date | 2015-06-01 | Insurance policy end date | 2016-05-31 | Total amount of commissions paid to insurance broker | USD $15,240 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $101,600 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $12,973 | Insurance broker organization code? | 3 | Insurance broker name | LOCKTON COMPANIES LLC |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 000000604175 |
Policy instance | 3 |
Insurance contract or identification number | 000000604175 | Number of Individuals Covered | 118 | Insurance policy start date | 2015-06-01 | Insurance policy end date | 2016-05-31 | Total amount of commissions paid to insurance broker | USD $14,305 | Other welfare benefits provided | LIFESTYLE ADD; LIFESTYLE LIFE | Welfare Benefit Premiums Paid to Carrier | USD $64,724 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $14,305 | Insurance broker organization code? | 3 | Insurance broker name | KORE INSURANCE HOLDINGS LLC |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 099469 |
Policy instance | 2 |
Insurance contract or identification number | 099469 | Number of Individuals Covered | 365 | Insurance policy start date | 2015-06-01 | Insurance policy end date | 2016-05-31 | Total amount of commissions paid to insurance broker | USD $1,984 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $21,921 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,984 | Insurance broker organization code? | 3 | Insurance broker name | KORE INSURANCE HOLDINGS LLC |
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HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
Policy contract number | 86551 |
Policy instance | 1 |
Insurance contract or identification number | 86551 | Number of Individuals Covered | 367 | Insurance policy start date | 2014-09-01 | Insurance policy end date | 2015-08-31 | Total amount of commissions paid to insurance broker | USD $124,842 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $4,015,335 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $124,842 | Insurance broker organization code? | 3 | Insurance broker name | KORE HEALTH AND BENEFITS LLC |
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HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
Policy contract number | 86551 |
Policy instance | 1 |
Insurance contract or identification number | 86551 | Number of Individuals Covered | 336 | Insurance policy start date | 2014-06-01 | Insurance policy end date | 2014-08-31 | Total amount of commissions paid to insurance broker | USD $29,555 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $840,539 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $29,555 | Insurance broker organization code? | 3 | Insurance broker name | KORE HEALTH AND BENEFITS LLC |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 604174 |
Policy instance | 3 |
Insurance contract or identification number | 604174 | Number of Individuals Covered | 80 | Insurance policy start date | 2014-08-01 | Insurance policy end date | 2015-05-31 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $31,147 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 099469 |
Policy instance | 2 |
Insurance contract or identification number | 099469 | Number of Individuals Covered | 411 | Insurance policy start date | 2014-06-01 | Insurance policy end date | 2015-05-31 | Total amount of commissions paid to insurance broker | USD $1,968 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $21,686 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,968 | Insurance broker organization code? | 3 | Insurance broker name | KORE HEALTH AND BENEFITS, LLC |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 604175 |
Policy instance | 4 |
Insurance contract or identification number | 604175 | Number of Individuals Covered | 124 | Insurance policy start date | 2014-08-01 | Insurance policy end date | 2015-05-31 | Other welfare benefits provided | LIFESTYLE ADD/ LIFESTYLE LIFE | Welfare Benefit Premiums Paid to Carrier | USD $50,666 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
Policy contract number | 0010257106 |
Policy instance | 5 |
Insurance contract or identification number | 0010257106 | Number of Individuals Covered | 8 | Insurance policy start date | 2014-06-01 | Insurance policy end date | 2015-05-31 | Total amount of commissions paid to insurance broker | USD $882 | Other welfare benefits provided | VOLUNTARY BENEFITS (ISTD) | Welfare Benefit Premiums Paid to Carrier | USD $2,450 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker organization code? | 3 | Commission paid to Insurance Broker | USD $882 | Insurance broker name | KORE INSURANCE HOLDINGS LLC |
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HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
Policy contract number | 86551 |
Policy instance | 1 |
Insurance contract or identification number | 86551 | Number of Individuals Covered | 338 | Insurance policy start date | 2013-06-01 | Insurance policy end date | 2014-05-31 | Total amount of commissions paid to insurance broker | USD $113,822 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,309,911 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | Commission paid to Insurance Broker | USD $113,822 | Insurance broker name | KORE HEALTH AND BENEFITS LLC |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 099469 |
Policy instance | 2 |
Insurance contract or identification number | 099469 | Number of Individuals Covered | 356 | Insurance policy start date | 2013-06-01 | Insurance policy end date | 2014-06-01 | Total amount of commissions paid to insurance broker | USD $3,026 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ADD | Welfare Benefit Premiums Paid to Carrier | USD $20,203 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,026 | Insurance broker organization code? | 3 | Insurance broker name | KARE HEALTH AND BENEFITS, LLC |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 696717 |
Policy instance | 1 |
Insurance contract or identification number | 696717 | Number of Individuals Covered | 811 | Insurance policy start date | 2012-06-01 | Insurance policy end date | 2013-05-31 | Total amount of commissions paid to insurance broker | USD $35,753 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $903,205 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $34,623 | Insurance broker organization code? | 3 | Insurance broker name | WELLS FARGO INSURANCE SERVICES USA |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 000FG278 |
Policy instance | 4 |
Insurance contract or identification number | 000FG278 | Number of Individuals Covered | 172 | Insurance policy start date | 2012-06-01 | Insurance policy end date | 2013-05-31 | Total amount of commissions paid to insurance broker | USD $13,666 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Other welfare benefits provided | OPTIONAL LIFE | Welfare Benefit Premiums Paid to Carrier | USD $91,106 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $13,666 | Insurance broker organization code? | 3 | Insurance broker name | WELLS FARGO INSURANCE SERVICES USA |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 099469 |
Policy instance | 3 |
Insurance contract or identification number | 099469 | Number of Individuals Covered | 357 | Insurance policy start date | 2012-06-01 | Insurance policy end date | 2013-06-01 | Total amount of commissions paid to insurance broker | USD $1,019 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ADD | Welfare Benefit Premiums Paid to Carrier | USD $19,007 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,019 | Insurance broker organization code? | 3 | Insurance broker name | THE AIGIS GROUP LLC |
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AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95287 ) |
Policy contract number | 696717-HNO |
Policy instance | 2 |
Insurance contract or identification number | 696717-HNO | Number of Individuals Covered | 652 | Insurance policy start date | 2012-06-01 | Insurance policy end date | 2013-05-31 | Total amount of commissions paid to insurance broker | USD $111,106 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Welfare Benefit Premiums Paid to Carrier | USD $134,096 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $101,786 | Insurance broker organization code? | 3 | Insurance broker name | WELLS FARGO INSURANCE SERVICES USA |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 696717 |
Policy instance | 1 |
Insurance contract or identification number | 696717 | Number of Individuals Covered | 1709 | Insurance policy start date | 2011-06-01 | Insurance policy end date | 2012-05-31 | Total amount of commissions paid to insurance broker | USD $40,174 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,218,165 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 0101012 |
Policy instance | 2 |
Insurance contract or identification number | 0101012 | Number of Individuals Covered | 745 | Insurance policy start date | 2011-06-01 | Insurance policy end date | 2012-05-31 | Total amount of commissions paid to insurance broker | USD $9,954 | Total amount of fees paid to insurance company | USD $900 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $107,773 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 696717-HNO |
Policy instance | 4 |
Insurance contract or identification number | 696717-HNO | Number of Individuals Covered | 1501 | Insurance policy start date | 2011-06-01 | Insurance policy end date | 2012-05-31 | Total amount of commissions paid to insurance broker | USD $218,377 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Welfare Benefit Premiums Paid to Carrier | USD $5,859,649 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | FG278 |
Policy instance | 3 |
Insurance contract or identification number | FG278 | Number of Individuals Covered | 161 | Insurance policy start date | 2011-06-01 | Insurance policy end date | 2012-05-31 | Total amount of commissions paid to insurance broker | USD $11,595 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Other welfare benefits provided | OPTIONAL LIFE | Welfare Benefit Premiums Paid to Carrier | USD $77,298 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 696717 |
Policy instance | 1 |
Insurance contract or identification number | 696717 | Number of Individuals Covered | 1510 | Insurance policy start date | 2010-06-01 | Insurance policy end date | 2011-05-31 | Total amount of commissions paid to insurance broker | USD $200,622 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $5,302,620 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | FG278 |
Policy instance | 3 |
Insurance contract or identification number | FG278 | Number of Individuals Covered | 154 | Insurance policy start date | 2010-06-01 | Insurance policy end date | 2011-05-31 | Total amount of commissions paid to insurance broker | USD $11,313 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Other welfare benefits provided | OPTIONAL LIFE | Welfare Benefit Premiums Paid to Carrier | USD $75,417 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 0101012 |
Policy instance | 2 |
Insurance contract or identification number | 0101012 | Number of Individuals Covered | 671 | Insurance policy start date | 2010-05-01 | Insurance policy end date | 2011-04-30 | Total amount of commissions paid to insurance broker | USD $8,650 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $91,934 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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